Changes in diabetes distress among people with type 2 diabetes during a risk screening programme for diabetic kidney disease - Longitudinal observations of the PRIORITY study

Associations between use of diabetes technology and diabetes distress: a Danish cross-sectional survey of adults with type 1 diabetes

INTRODUCTION

The study aimed to investigate independent and combined associations between insulin delivery method (insulin pump therapy (IPT) vs multiple daily injections (MDI)), glucose monitoring method (intermittently scanned continuous glucose monitoring (isCGM) and real-time continuous glucose monitoring (rtCGM) vs blood glucose metre (BGM)) and diabetes distress (DD) in adults with type 1 diabetes (T1D).

RESEARCH DESIGN AND METHODS

We combined data from two Danish questionnaire-based surveys, the Steno Tech Survey (n=1591) and the Type 1 Diabetes Distress Scale (T1-DDS) validation survey (n=4205), in which individuals aged ≥18 years with T1D were invited to participate. The 28-item T1-DDS was used to measure DD and DD scores were categorised as little or no distress (score <2.0), moderate distress (2.0-2.9) and high distress (score ≥3.0). Associations between insulin delivery, glucose monitoring methods and DD were assessed using linear regression.

RESULTS

Among 2068 adults with T1D who responded to one of the surveys, the use of IPT was associated with a lower total T1-DDS score (-0.09, 95% CI 0.16 to -0.03) compared with MDI and adjusted for glucose monitoring method. The use of CGM was associated with a higher total T1-DDS score (0.11, 95% CI 0.05 to 0.18) compared with BGM and adjusted for the insulin delivery method. IPT was still associated with a lower T1-DDS score, regardless of being combined with BGM (-0.17, 95% CI -0.28 to -0.06) or CGM (-0.13, 95% CI -0.21 to -0.05), compared with MDI with CGM. No association was found between the type of CGM (isCGM vs rtCGM) and DD among either IPT or MDI users when restricting analysis to individuals using CGM.

CONCLUSIONS

Among Danish adults with T1D, the use of IPT was associated with lower levels of DD, while CGM use was associated with higher levels of DD. DD should be addressed when introducing people with T1D to diabetes technology, CGM in particular.

TRIAL REGISTRATION NUMBER

NCT04311164 (Results).

PPARɣ2, aldose reductase, and TCF7L2 gene polymorphisms: relation to diabetes mellitus

Purpose

Diabetes mellitus (DM) is a growing global health concern. Genetic factors play a pivotal role in the development of diabetes. Therefore, the present work aimed to study the relation between peroxisome proliferator-activate receptors (PPARɣ2) (rs3856806), aldose reductase (AR) (rs759853), transcription factor 7 like 2 (TCF7L2) (rs7903146) gene polymorphism with diabetes in the Egyptian population.

Methods

The study included 260 diabetics and 120 healthy subjects. Genotyping was done using polymerase chain reaction-restriction fragment length polymorphism.

Results

Regression analysis revealed that PPARɣ2 TT, TCF7L2 TT were suggested to be independent risk predictors for T1DM and TCF7L2 TC, CC genotype were suggested to be independent protective factors against T1DM development. On the other hand, PPARɣ2 TT, AR TT genotypes were suggested to be independent risk predictors for T2DM susceptibility, and PPARɣ2 CT genotypes were suggested to be independent protective factors against T2DM development.

Conclusion

The present study revealed that PPARγ2 (rs3856806), TCF7L2 (rs7903146) and AR (rs759853) gene polymorphism may play an important role in the susceptibility of diabetes. Therefore, these polymorphisms may have a prognostic value for diabetes in the Egyptian population. Further work is required to confirm the role of these polymorphisms in diabetes.

Exploring protective factors through positive psychology and salutogenesis in Danish families with type 2 diabetes

People with type 2 diabetes (T2D) live with several challenges, which may enhance the risk of poor mental and physical health. However, despite living with a chronic illness, some individuals manage to achieve a life with positivity and well-being. The objective of this study is to explore the potential of Positive Psychology and Salutogenesis when analyzing how families with one or more members with T2D experience having resources leading to thriving. Data consist of 18 semi-structured family interviews with 38 participants. Data were analyzed using systematic text condensation with the concepts of sense of coherence and upward/downward spirals as the analytical framework. The analysis revealed three overall findings: (i) T2D is perceived as manageable due to general optimism despite living with a chronic illness; (ii) establishing supportive social relations means having the opportunity to share the burden of diabetes; and (iii) achieving an open dialogue and communicating the difficulties of diabetes without straining surroundings with negative illness communication. The three overall findings may reinforce each other in an upward spiral and enhance the sense of coherence. These findings have implications for diabetes management research and our understanding of psychological health in chronic illness. The overall goal is to help people with diabetes create meaning with their illness and make use of their social environment through dialogue and communication in order to increase positivity, optimism and mental health.